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Relationship between the clinical characteristics and the outcome of the head-up tilt test in syncopal children

Agnieszka Zygmunt, Piotr Kędziora, Magdalena Pierzchała, Beata Kierzkowska, Jerzy Stańczyk

Med Sci Tech 2006; 47(4): RA259-263

ID: 881530

Introduction: Application of the head-up tilt test (HUT) was a turning point in the diagnosis of syncope. The goal of the present study was to examine the association between the outcome of the HUT and clinical characteristics of syncope in children. Material and Methods: We studied 229 children, aged 7-18 (mean ± SD: 14.01 ± 2.56 years), 158 girls and 71 boys, referred to our clinic for evaluation of unexplained syncope or presyncope, who underwent HUT as part of the diagnostic work-up. We assessed the relationship between the HUT outcome and the age and sex of a child as well as the number of syncopal episodes and their characteristics. Results: The positive response to HUT, allowing for final diagnosis of vasovagalsyncope establishment, was observed in 123 of 229 examined children (53.7%). There was no association between HUT result and the age and sex of a patient. Moreover, we have not found any correlation between the frequency of positive HUT and the number of syncopal episodes. The fact whether a child experienced full loss of consciousness or just presyncope has not seemed to influence the outcome of the HUT either. The positive HUT was, however, over twice as frequent in the group of patients with a history characteristic of a vasovagal syncope. Conclusions: 1. HUT is a useful examination tool in establishing the diagnosis of vasovagal syncope in children. 2. The test outcome, however, does not fully reflect the severity of the disorder and thus seems to have limited application in the choice of treatment. (Clin. Exp. Med. Lett. 2006; 47(4):259-263)

Keywords: head-up tilt test, syncope,, children

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